The applicant ("I," "me" or "my") represents that all information provided with my application is true and correct and hereby authorizes Warren Capital Corporation and/or its assigns ("WCC") to obtain information from my accountant and any other source(s) which WCC may contact relative to this application-each such source being hereby authorized to provide WCC with such information. I authorize WCC to provide to other qualified credit grantors such information and any information relating to my dealings with WCC as they may request. This application shall be and remain WCC's property.

If this application for business credit is denied, I have the right to a written statement of the specific reasons for the denial. To obtain the statement, I may contact Warren Capital Corporation at 100 Rowland Way, Suite 205, Novato, CA 94945, (415) 898-1875 within 60 days from the date I am notified of WCC's decision. WCC will send me a written statement of reasons for the denial within 30 days of receiving my request for the statement.

Notice! The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applications on the basis of race, color, religion, national origin, sex, marital status, or age (provided the applicant has the capacity to enter into a binding contract); or because all or part of the applicant's income derives from any public assistance program or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance with this law concerning this creditor is the Federal Trade, Equal Credit Opportunity, Washington, D.C. 20580.

By signing below on my behalf, each individual, who is either a principal or a guarantor of my obligations, authorizes Warren Capital Corporation, its nominees or assigns, to obtain and review his/her personal credit profile from a national credit bureau. Such authorization shall extend to obtaining a credit profile subsequently for the purpose of update or in connection with renewal or extension of the credit requested herein or a request for additional credit as well as for reviewing and collecting the resulting account. A photostat or facsimile copy of this authorization shall be as valid as the original. By indicating below, each signator identified above affirms his/her identity as the respective individual identified above.

I have read the above terms and by checking this box I signify that I agree to these conditions.